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NPI Code Detail

MEDICARE: DR. DOUGLAS N WHATMORE M.D.

MEDICARE: DR. DOUGLAS N WHATMORE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianM6630ID

General Provider Information

NPI Number : 1023168523
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS N WHATMORE M.D.
Provider Business Mailing Address
First Line : 3200 CHANNING WAY
Second Line : STE 205
City : IDAHO FALLS
State : ID
Zip : 83404-7546
Country : US
Telephone Number : 208-535-4300
Fax Number : 208-535-4315
Provider Business Practice Location Address
First Line : 3200 CHANNING WAY
Second Line : STE 205
City : IDAHO FALLS
State : ID
Zip : 83404-7546
Country : US
Telephone Number : 208-535-4300
Fax Number : 208-535-4315
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 06/21/2026

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